In the field of prophylactic diagnosis it is important to have available a reliable analytical method for the quantitative analysis of triglycerides, i.e. one which provides reproduceable data.
An increase in the blood serum of the concentration of lipides, understood to include triglyderides, cholesterol derivatives and the phospholipides is seldom accompanied by clinical symptoms, nevertheless such increases are important risk factors associated with arteriosclerosis and the coronary diseases.
In contrast to the comparatively unspecific analysis for total lipides the quantitive analysis of the triglycerides and the cholesterol derivatives allows, in about 90 percent of cases, a specific diagnosis as to the type of the hyperlipidemy.
Such hyperlipidemies (also referred to as hyperlipoproteinemies since the fatty acid components or the lipides are rendered soluble in the aqueous transportation system of the human by bonding to proteins) can be diagnozed according to known prior methods by an analysis of the alcohol component, i.e. the glycerol of the fatty acid ester.
In order to analyze the fatty acid content it is necessary that the triglyceride be separated from the protein substrate and then saponified. These prior art methods give a quantitative value for fatty acids based on the quantitative analysis of the glycerol as formed by the saponification.
In the prior art methods the hydrolysis of the ester is effected either by ordinary alkaline hydrolysis, as in soap manufacture, which employs an alcoholic potassium hydroxide solution (a reesterification), or by enzyme hydrolysis using enzymes which specifically result in the hydrolysis of the ester bond.
In these methods the glycerol obtained by hydrolysis of the ester is reacted with adenosine triphosphate in the presence of glycerol-kinase to form glycerol-1-phosphate, and the adenosine triphosphate formed is reacted with phosphoenol pyruvate in the presence of a pyruvate-kinase to form pyruvate and adenosine triphosphate. The pyruvate is reduced with the hydrogenated form of nicotinamide adeninedi nucleotide to lactate. The resulting dehydrogenation of nicotinamide adeninedi nucleotide can be optically analyzed quantitatively since only the hydrogenated form has an absorption at 340 nm.
The triglyceride content is taken as the difference between the content of blood glycerides and blood glycerol.
The two prior art methods described above for the hydrolysis of lipides are attended by certain disadvantages. The alkaline saponification requires the use of an elevated temperature of about 55 to 70.degree. C and a substantial time period, on the order of 20 to 30 55.degree. minutes. Also the ester cleavage by means enzymes requires close regulation of the temperature to optimize the reaction velocity and to ensure the full efficiency of the enzymes. Thus enzyme hydrolysis, which requires maintaining the reaction medium precisely at a temperature of about 30.degree. C, often poses difficulties to the ordinary practitioner, i.e. in the small laboratory of a practicing physician and performed by untrained personel. In this latter method, if the temperature is not properly maintained, the test inevitably results in erroneous data. Enzyme cleavage also requires a period of at least 10 minutes. An additional problem resides in the fact that the enzymes used for the hydrolysis show a decrease in activity (catalytic efficiency) upon storage, which introduces a further factor of uncertainty into the test. The enzymes are also comparatively expensive.